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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:08/05/2014FORM
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Facility number 004417 is a unique identification number assigned to a specific facility or location.
Any individual or organization that operates or owns the facility identified by number 004417 is required to file.
Facility number 004417 can be filled out by providing relevant information about the facility, such as location, operations, and ownership details.
The purpose of facility number 004417 is to accurately identify and track information related to a specific facility for regulatory or informational purposes.
Information such as facility name, address, contact details, operational activities, and ownership information may need to be reported on facility number 004417.
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